Purna is on a placement in southern Nepal

Purna is now in his 4th year of medical studies and is currently on a placement in a Primary Health Care Centre (PHCC) in Manhari, Makawanpur.  He is about 180km from Kathmandu and the posting lasts for 1 month.  PHCCs is the most basic level of healthcare institution offered by the government in Nepal.  It mostly provides A&E services,  curative health care services and preventative services.  Purna has recently had 2 interesting cases in which he was involved and here’s what he has to say about them:
“This is my first residential posting with with clinical exposure and I am in my second week of posting.  Altogether there are 7 medical students including me.  It’s VERY hot – the temperature ranges between 35 to 40 degs C.  The main objective of this posting is to make us familiar with PHCC services.  We are looking after a lot of patients from different remote areas in this district.  After completing of this posting I will have to make a report to include data analysis and presentation of my posting.”

“This man had a road accident 3 months ago.  He underwent an open reduction with an internal fixing, but unfortunately it failed and a malunion occured which means the bone has healed but not in the right position.  He therefore had to have another repair with an external fixing.  The man is from a very poor economic background and lives about 6km from the PHCC but has to come into our PHCC for his wound to be cleaned and dressed regularly.  That’s what I’m doing in the picture.”








“This patient is a 54 year old alcoholic man brought to our emergency department with massive bleeding, who cut his hand with his own with knife. The wound is nearly 1 cm deep. The vein was totally spared. He was brought to our emergency department by his neighbours in an unconscious state. With the assistance of an attending Staff nurse, I tied the vein with suture thread, and was able to stop the bleeding. We maintained IV access with Ringer lactate solution (it is used for replacing fluids and electrolytes in those who have low blood volume or low blood pressure). I gave him a tetanus injection and referred him, by ambulance, to the District hospital, which is in ‘Chitwan’.”